Halitosis: Types / Classifications

When a dental professional initiates a patient's treatment, they must first make an assessment of the type of breath condition from which they are suffering. This is important because the needed solution for different types of conditions varies significantly.

B) Pseudo-halitosis

This classification refers to a situation where an odor problem does not exist (cannot be detected by smell or scientific testing) but the patient still feels that they have bad breath. Since no real breath problem exists, treatment consists of counseling the patient about their misconception.

A study by Quirynen (2009) determined that pseudo-halitosis represents about 15% of cases. [page references]

C) Halitophobia

A situation where a patient's perception of a breath problem continues to exist despite the successful treatment of their genuine halitosis condition or, in the case of pseudo-halitosis, after receiving counseling. At this point, treatment for the patient's condition needs to be referred to a medical professional who can provide appropriate psychological counseling.

The most common cause of Genuine halitosis is debris on the posterior portion of the tongue.

2) Physiologic Halitosis

This category refers to those situations where the person's malodor is attributable to putrefaction processes taking place in their oral cavity, frequently within the white-colored coating found on the posterior portion of their tongue (see illustration).

This is the most common form of bad breath, the type that 90% of cases involve. (Bartold 2016)

This classification of bad breath is considered to be transient, in the sense that its presence comes and goes (as determined by temporary localized conditions in the mouth) and that it can be relatively easily resolved.

The subcategories of Pathologic Halitosis.

The "pathologic" halitosis category is further divided into subcategories, based on the location of the disease process that is associated with the patient's breath problem.

1) Oral Pathologic Halitosis

This category includes situations where the person's odor problems are caused, or aggravated, by disease or other pathologic conditions associated with tissues inside the mouth.

As a primary example, the level of malodor experienced can be aggravated by the presence of periodontal disease (gum disease). Co-factors (such as dry mouth, smoking or teeth in need of repair) can play a role too.

2) Extraoral Pathologic Halitosis

Sinus discharge can be the cause of breath odors.

With this classification, the person's breath malodor originates from a disease or a pathologic condition involving body tissues other than in the mouth. The odor may originate from: